What I Thought I Knew: A Memoir (5 page)

Dr. Katzen sketched some more, on gender-neutral yellow Post-its, to show us how he could create a functional vagina in our baby, should hers be missing.

“Wow!” What else could I say to the surgeon who promised he could turn my baby’s penis into a clitoris, and fabricate a vagina into my vagina-less little girl.

“Have you done many of these surgeries?” I ask.

“No. Just a few. As many as any surgeon has. Genital ambiguity is extremely rare.”

“Is surgery always recommended?” Michael asked.

“The American Medical Association recommends corrective surgery for children with ambiguous genitalia.” Katzen’s face darkened. “However, the transgender activists are against it. They abhor the term
normalcy
. They say surgery robs them of their unique gender identity and diminishes sexual sensation. They think every child with ambiguous genitals should have the privilege of saying, ‘It’s my body, it’s not like anybody else’s body, and I like it the way it is.’ Which is total bullshit! How is a twelve-year-old boy without a penis going to feel when the other boys taunt him in the locker room? How will a teenage girl with a penis feel when her boyfriend rejects her in disgust? It’s cruel to subject boys and girls to that kind of humiliation!”

He cleared his throat and settled back in his chair. “I urge you to consider surgical correction.”

 

 

Michael and I took his sketches home with us.

We’ve known for less than a week that we’re having a baby in three months. Now we have to face the ethical dilemma of whether to surgically correct her penis. Katzen’s solution sounds at least as dogmatic as that of the transgender activists, and terrifyingly irreversible. In the meantime, the gender ambiguity made choosing a name . . . complicated.

Genital ambiguity has few known causes. Exposure to excessive hormones in utero, such as the synthetic estrogen I was taking for the first six months of pregnancy, can cause birth defects, including genital deformity. It can also be caused by CAH (Congenital Adrenal Hyperplasia), a rare, salt-wasting genetic disease, fatal if not treated daily. Genital ambiguity is the only outward physical sign of CAH.

Dr. Wong, at New York Hospital, was an expert on Congenital Adrenal Hyperplasia. Her beautiful young associate Dr. Melina Christopoulos wore a short white robe over her red miniskirt and thigh-high black boots. Her Greek-accented breathy voice enhanced her hot-chick-in-a-doctor’s-robe look.

“All you need is love for baby,” says Dr. Christopoulos. “Do not worry for CAH. Like diabetes, but easier. No shots. Give one pill a day, or she will die. So easy. All she needs is love and one pill. CAH girls are strong and athletic. Many grow up to be lesbians. But I think your baby does not have CAH. I think her penis is from estrogen pills Alice took during pregnancy. I will look at baby on day she is born. If genital ambiguity, I will take her to emergency room to rule out CAH.”

 

 

“It’s going to be okay, Alice,” says Michael.

I don’t share his confidence.

At home, I read the twelve-page patient information insert from my hormone prescription.
“Do not take during pregnancy. . . . Deformities in newborn rats when taken during pregnancy. . . . Abnormal masculinization of female genitals.”
The pill I took every day for the first six months of pregnancy caused this baby girl to have a penis. And who knows what other injuries, as yet undetected, she has; what cancer time bomb might detonate?

“You’re overthinking this,” says Michael, accurately.

What have I done? Fourteen years ago I’d longed to get pregnant and have a baby. Fourteen years ago, I knew I would take care of my baby from the beginning of my pregnancy. I would never bring a baby into the world this way! I’ve injured her. Let me start over.

But
start over
is my not-so-secret code for
abortion
, and it’s too late for an abortion, and this is too terrible a thought to tolerate now that we’ve all said yes to this baby and yes to being a family.

“She’ll be our baby, she’ll be great, we’ll be great,” says Michael, and he means it. But he can tell he’s not getting through to me. He can tell I’m tumbling into an abyss, and it scares both of us.

I had been unhappy before, but I had never thought about killing myself. I’ve never been able to watch violent scenes in movies. I usually close my eyes before the shooting starts. Now when I close my eyes, and sometimes with my eyes open, I see violent scenes in which I play the central, fatal role.

Scene 2

“On Rosh Hashanah it is written. On Yom Kippur it is sealed.”

Aware of my suicidal fantasies, Sue called her well-connected friend Erica, who called her well-connected aunt Charlotte (a chapter president of Planned Parenthood), who called her brother, Erica’s father (a well-connected doctor), who pulled some strings for me to see Dr. Raushbaum, a feared and revered abortion specialist at New York Hospital.

I go to synagogue two times a year, on Rosh Hashanah and on Yom Kippur. This year I started Rosh Hashanah in the metal cylinder of a CAT scan. I would spend Yom Kippur, the Jewish day of fasting and atonement, in Dr. Raushbaum’s office arranging for a late-term abortion. It was ten days after I found out I was pregnant.

Michael came with me. Seventyish and stout, the doctor sat in an old leather chair at a heavy wooden desk, heaped with unsteady mountains of papers. He chewed on an unlit cigar and inspected us over his beakish nose.

“Tell me exactly how it came about that you are six months pregnant but you didn’t find out about it until last week.”

I told him.

“Your story is remarkable. Your doctors are incompetent idiots.” He leaned over his desk, rolled his cigar around with his tongue, and glared at me. “You’re also an idiot! You were in denial for the past six months. Every woman knows subliminally when she’s pregnant. You must have felt the baby kicking, didn’t you?”

“No, I didn’t.”

He dismissed my protests with a snort, a wave of his hand, a roll of his cigar. “Let’s get to the business at hand. Tell me why you requested this urgent meeting on Yom Kippur, the holiest day of the year, the day God decides who is and who is not inscribed into the Book of Life. Not that I care, I’m an atheist.”

“I don’t want to have a baby. I’m depressed and terrified. I had no prenatal care for the first six months, and the baby was subjected to drugs and X-rays, a CAT scan—”

“Yes, and?”

“—And she’s a female but she has a penis, and she might have CAH, a fatal salt-wasting—”

“Yes, and?”

“—And I’m scared I’ll go into labor any day and the baby will be premature and severely disabled and—”

“Yes, and?”

“Why do you keep saying, ‘yes, and’?”

“Is your life in danger?”

“What do you mean?”

His thick eyebrows joined to form one thick line. “I don’t have time for stupidity. Why are you in my office? I can’t legally put words into your mouth. Exactly how depressed are you?”

“I think about killing myself.”

“Thank you! I’m sorry you’re so unhappy, but that’s why we’re here, isn’t it? Since you’re contemplating suicide, the mother’s life is in danger, which is the only way you can get a legal abortion. Not in New York State, which has no exception to the twenty-four-week limit. You could, however, have an abortion in Wichita, Kansas.”

I can’t think of a less likely place for liberal abortion laws. I’ve been to Wichita. My very first solo tour, when I was twenty-eight, was two weeks in south-central Kansas. Antigay and antiabortion protesters accosted travelers in the airport with leaflets and recruitment entreaties.

“In Kansas, if the mother’s life is in danger, an abortion is legal up until the twenty-eighth week. Seven days from today. Do you want me to call the abortion clinic in Wichita right now?”

I nodded. He called Wichita and scheduled an abortion for Tuesday, in one week.

“Now it’s in your hands. You can call and discuss it with them. You can think about it for the next few days before you decide. Meanwhile, I’ll get you an appointment with Dr. Carrie Rosenbloom. She is the only doctor you should be seeing for this pregnancy. The best high-risk obstetrician in the country.

“I already called her. She wouldn’t see me.”

“She’ll see you, because I’ll tell her to. And let’s get the goddamn penis question straightened out. It’s hard to read a sonogram. It’s a bunch of gray dots on a screen. Your guy might have thought he saw a penis, but maybe he saw the umbilical cord, or some other gray specks. There’s a guy here who’s the best sonographer in the world. He’s going to look at the baby. But he’s Catholic and a right-to-lifer with eleven kids, so don’t let him know you’re considering an abortion.”

“He would allow his religious beliefs to affect the way he reads a sonogram?”

“Of course he would. A doctor is a person. We see what we see through a variety of lenses—the lens of science, of politics, religion, our personal passions. Reading a sonogram is not an exact science. If you mention abortion, he’ll view the ambiguous gray dots on the screen through his right-to-life lens, and I guarantee you he will not see a penis.”

Raushbaum swiveled his chair toward Michael. “What do you think about all this?”

“Me? Oh, Jesus . . . a lot of different things. I’ve seen Alice in the throes of this terrible unhappiness and . . . I don’t recognize her. And I think her . . . misery is actually less about having a baby than it is about losing her freedom to choose. She feels imprisoned, and it’s . . . it’s making her go crazy. So for the first time in my life—and I come from an extremely conservative, antiabortion, southern Christian family where the abortion issue is totally black and white, no room for discussion—I’m sick just imagining what my family would even think if they knew we were talking to you about—For the first time, I’ve had to genuinely think about abortion rights. It’s always been an abstraction. I’ve been politically in favor of choice, but uncommitted on the personal side. Because it’s suddenly so real and imminent a question in our lives, I . . . for the first time I understand the importance of a woman’s right to choose. But the equally compelling personal truth for me is that there’s a baby. Our baby. My baby. And I don’t care if she has a penis or two penises or a salt-wasting disease or three heads or . . . I can’t stand the thought of this baby being aborted. So if Alice has an abortion, I won’t go to Wichita with her. And I might not be here when she gets back. I’ll have my own unbearable sorrow about losing this baby, about endorsing this decision. I’ll have that sorrow for the rest of my life. But I don’t want Alice to kill herself. So she should do what she needs to do. That’s what I think about all this.”

Dr. Raushbaum nodded at Michael, leaned back in his leather chair, chewed on his cigar, and looked at me.

“I have a two-year-old grandson. He’s cute, but I get bored of him after twenty minutes. It takes forever to raise a child till it’s old enough to be interesting. I couldn’t do it again. But I’m not you. I wonder what you’ll decide.”

 

 

“I don’t see a penis! I see a large labia and a large clitoris!” shouts the evangelist sonographer from New York Hospital at the gray shapes on the monitor. He knows the referral has come from well-known abortion doctor Dr. Raushbaum, who considers him the best sonographer in the world.

 

 

“I see a small penis and partially fused scrotum,” declares the sonographer in Boston, whom Dr. Rosenbloom considers the best sonographer in the world, to whom she has sent me for a third opinion.

Michael and I halfheartedly pretend the four-hour drive home from Boston is an ordinary outing. We don’t talk about the contradictory, inconclusive readings we’ve gotten from the world’s greatest sonographers. We don’t talk about Wichita. We listen to the radio, switching to stations with the best reception as we drive south. I briefly get National Public Radio.

“In the next few weeks, somewhere in the world, a baby will be born. And that baby will bring the world population to six billion! The UN has prepared a report called ‘The World at Six Billion’ in response to the global attention to this historic milestone and widespread concerns about overpopula—” The rest of the story is obscured by static.